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Oral Surgery · single question

A patient on zoledronic acid (Zometa) had an extraction elsewhere and now has exposed bone with draining pus at the site. The diagnosis is:

  1. Medication-related osteonecrosis of the jaw (MRONJ)
  2. Osteomyelitis from caries
  3. Dry socket
  4. Periapical abscess
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Correct answer: A. Medication-related osteonecrosis of the jaw (MRONJ)

  • A. Correct. Exposed, non-healing bone (>8 weeks) in a patient on antiresorptive therapy (bisphosphonate) after dental surgery defines MRONJ.
  • B. While infection can be superimposed, the antiresorptive history + exposed bone defines MRONJ.
  • C. Dry socket is a painful empty socket without persistent exposed necrotic bone over weeks.
  • D. A periapical abscess relates to a non-vital tooth, not exposed necrotic bone post-extraction in an antiresorptive patient.

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